What are my options?

Gyno Guide: Pain and Discomfort Options

No two bodies are the same. Everyone has a different experience during gynecological care, along with varying perceptions of pain. While some people go through routine procedures and screening tests with little or mild discomfort, others may experience greater discomfort and seek options for pain intervention. In preparation for your appointment, you may want to call your healthcare provider and consult a few days ahead to explore what pain intervention methods will be accessible to you during your procedure or exam in the event that you feel you need them.

This guide is meant to be a resource to jumpstart your research on options for pain intervention and mediation during routine gynecological procedures and exams such as IUD insertions and pap smears. The guide does not serve as medical advice. We do not promote, or endorse any one method over another. Engaging in conversation with your healthcare provider before opting for any pain relief before, during, or after your procedure or examination may be a key step to identifying which pain intervention method is best for you.

This guide is not an extensive list of options for pain intervention and mediation, and we recognize that the options presented here may be limited by financial or time constraints. e strongly encourage you to check out the additional resources provided at the bottom of the guide for further information on your options.

What are you dealing with?

If you’re going in for a scheduled PAP or IUD insertion, it might be helpful to know the steps or receive verbal counseling throughout. If you have had painful exams or procedures before, let your provider know.

Medicinal Options

Over-the-counter pain relief

Over-the-counter pain medication can be effective in reducing discomfort when taken as directed. When you schedule your appointment, ask if you can take any over-the-counter pain medication, such as ibuprofen, acetaminophen, or a combination of the two, before you arrive.

Cervical Block

For some procedures like IUD insertion or biopsy, a local anesthetic or a similar solution might be appropriate. A local anesthetic is sometimes referred to as a “cervical block”. It should be noted that although this may temporarily reduce pain during the procedure, it does not prevent cramping after an IUD is inserted.

Addressing Discomfort Before the Procedure

While uncommon, some people may experience pain even before the procedure. This could be due to a pre-existing condition that is the cause for the procedure or exam. If this is your situation, you may want to consider the following:

Let your provider know if you cannot comfortably insert a finger or tampon into your vagina, as this could help them understand your needs during certain exams and procedures.
Let your healthcare provider know if you have pain on your vulva or any outside skin. For people with vulva pain, lidocaine gel or a similar solution might be presented to you, or you can ask if this is an appropriate option. This will reduce sensation on the skin, which is why it can be an option for some people with vulvar pain.
If you have pain in your vagina before the procedure or exam, let your healthcare provider know. This could help them better accommodate you by being more gentle or trying to get a sample quicker.

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Getting Comfortable In the Stirrups

Tensing leg, back, abdominal, and pelvic muscles can cause discomfort during an exam or procedure. However “relaxing” during a gynecology appointment may be easier said than done. If you anticipate that getting your body comfortable may be a challenge for you, below are some tips to try out and see what works for you:

You have the right to not rush through your appointment. When the provider asks you get in position, let them know that you may need a minute to get comfortable to avoid tensing
Place your legs on the stirrups in a way that allows your legs rest without the need to tense your muscles to hold them in place
Scoot down toward the edge of the seat, so that your butt is nearly off of it. It is okay if this doesn’t feel natural at first– imagine this area getting heavier onto the table and let your bodyweight sink down.
Deep belly breathing might help before an exam: imagine filling your lower abdomen with air gently can help ease some abdominal tension.
Notice any clenching of the jaw or shoulders. This may feel like you are hunching over, or that your jaw and teeth are tight. Try releasing this tension as well before the procedure or exam begins.
If you’re in the chair for a procedure like an IUD or biopsy, asking for a countdown might be effective, when possible. Similarly, you can also ask for a heads-up during the halfway point or near the end.
Ask about the speculum size. If you’ve had a difficult time avoiding tension during a procedure involving a speculum, ask them to size down. In some cases, a smaller speculum might not be appropriate due to the procedure- you’re allowed to ask what size and why they chose it.
Empty your bladder before the exam or pap smear unless otherwise directed (such as for a bladder ultrasound or urine sample). If you need to use the bathroom- go ahead! It may help you reduce tension in your pelvis during the exam or procedure if you aren’t holding in urine, gas, or a bowel movement.
Once you feel comfortable, let your provider know that you are ready to begin.

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Treating Pain After

If applicable, use a heating pad after your exam or procedure if you’re experiencing cramping. For certain procedures, this isn’t recommended- so as always, ask your healthcare provider if you can use heat on your lower abdomen or back. Ask what over-the-counter medication you can take if you experience cramping after the procedure, such as ibuprofen or acetaminophen.

Ask your healthcare provider if these options are outside of the scope of your procedure concerns.